Correlation between Immune Complexes and Prognostic Factors in Hodgkin's Disease

P. L. Amlot; B. Pussell; J. M. Slaney; B. D. Williams

doi:10.1042/cs054020pd

Outcome of patients with Hodgkin's disease failing after primary MOPP-ABVD.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.2.528 ◽

1997 ◽

Vol 15 (2) ◽

pp. 528-534 ◽

Cited By ~ 138

Author(s):

V Bonfante ◽

A Santoro ◽

S Viviani ◽

L Devizzi ◽

M Balzarotti ◽

...

Keyword(s):

Prognostic Factors ◽

Complete Remission ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Response Duration ◽

Long Term Results ◽

High Dose ◽

First Line ◽

Disease Extent

PURPOSE This study analyzed long-term results in patients with Hodgkin's disease who were resistant to or relapsed after first-line treatment with MOPP and ABVD. Response to salvage treatments and prognostic factors were also evaluated. PATIENTS AND METHODS The study population included 115 refractory or relapsed patients among a total of 415 patients treated with alternating or hybrid MOPP-ABVD followed by radiotherapy (25 to 30 Gy) to initial bulky sites. The median follow-up duration of the present series was 91 months. Thirty-nine of 115 patients (34%) showed disease progression while on primary treatment (induction failures); 48 relapsed after complete remissions that lasted < or = 12 months and 28 after complete remission that lasted more than 12 months from the end of all treatments. RESULTS At 8 years, the overall survival rate was 27%, being 54% and 28% in patients whose initial complete remission was longer or shorter than 12 months, respectively, and 8% in induction failures (P < .001). Response to first-line chemotherapy and disease extent at first progression significantly influenced long-term results, as well as the incidence and duration of complete remission. CONCLUSION The present data confirm previous observations that showed the main prognostic factors to influence outcome after salvage treatment are response duration to first-line therapy and disease extent at relapse. The results indicate that patients who relapse after the alternating MOPP/ABVD regimen have a prognosis similar to that of patients who relapse after a four-drug regimen (MOPP or ABVD alone). Re-treatment with initial chemotherapy seems the treatment of choice for patients who relapse after an initial complete remission that lasts greater than 12 months, while the real impact of high-dose chemotherapy or new regimens should be assessed in resistant patients.

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Clinical stages I and II Hodgkin's disease: a specifically tailored therapy according to prognostic factors.

Journal of Clinical Oncology ◽

10.1200/jco.1988.6.2.239 ◽

1988 ◽

Vol 6 (2) ◽

pp. 239-252 ◽

Cited By ~ 124

Author(s):

P Carde ◽

J M Burgers ◽

M Henry-Amar ◽

M Hayat ◽

W Sizoo ◽

...

Keyword(s):

Prognostic Factors ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Clinical Stage ◽

European Organization ◽

Free Survival ◽

Negative Laparotomy ◽

Extended Field ◽

The Difference ◽

Better Than

The H5 program in clinical stage (CS) I to II supradiaphragmatic Hodgkin's disease (HD) was tailored to prognostic factors identified in former European Organization for the Research and Treatment of Cancer (EORTC) studies. Among the 494 adult patients included in the study, the 237 patients belonging to the favorable group (H5F) underwent a staging laparotomy (Sx) in order to select the patients who could be treated with limited radiotherapy (RT) only. Thus, 198 patients (84%) with negative laparotomy were treated with RT alone and randomized to either mantle irradiation (M) or extended field mantle plus para-aortic (M + PA) irradiation. Complete remission (CR) was achieved in 99% of the patients. There was no difference in the 6-year relapse-free survival (RFS) rate (74% and 72%, respectively) or survival rate (96% and 89%). Therefore, Sx helped to define those patients who could be treated with M alone in contrast to those who required more aggressive therapy. The 39 patients with positive laparotomy were treated as the unfavorable group (H5U) from onset and randomized to either total/subtotal nodal irradiation (TNI/STNI) or a sandwiched mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) X 3, M irradiation, MOPP X 3 protocol (3M). Although the RFS rate was higher in the 3M arm (100% v 53%; P = .002), the 6-year survival was not significantly different between the two arms (overall, 92%). In the 257 patients with initial unfavorable disease, the Sx was avoided. They were randomized to either TNI/STNI or 3M. In complete responders (96%), the 6-year RFS was 91% in the 3M arm and 77% in the TNI/STNI arm (P = .02). The pattern of failure differed in the two arms: the inverted Y and spleen irradiation controlled occult infradiaphragmatic disease better than MOPP; conversely, less patients begun on MOPP recurred in the involved mantle areas. The difference in 6-year actuarial total survival (TS) (89% and 82%; P = .05 in favor of the 3M arm) was not retrieved after exclusion of the unrelated deaths from the analysis. The two arms produced similar TS in patients under 40 years of age. TNI retains interest, especially in young men wishing to preserve fertility. The overall result shows that when treatment is tailored to initial prognostic factors, excellent results can be obtained in all patient subgroups at minimal morbidity and toxic cost.

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Improved survival in patients with limited stage IIIA Hodgkin's disease treated with combined radiation therapy and chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.1994.12.12.2567 ◽

1994 ◽

Vol 12 (12) ◽

pp. 2567-2572 ◽

Cited By ~ 7

Author(s):

K C Marcus ◽

L A Kalish ◽

C N Coleman ◽

L N Shulman ◽

D S Rosenthal ◽

...

Keyword(s):

Radiation Therapy ◽

Prognostic Factors ◽

Survival Rate ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Survival Rates ◽

Stage Iii ◽

Combined Modality Treatment ◽

Stage Iiia ◽

Long Term Treatment

PURPOSE Patients with laparotomy-staged (PS) III 1A Hodgkin's disease confined to the upper abdomen are believed to have a favorable prognosis and require less aggressive treatment than patients with more-extensive stage III disease. We evaluated prognostic factors and outcome in 93 patients with PS III 1A Hodgkin's disease treated either with radiation therapy (RT) alone or combined RT and chemotherapy (combined modality treatment [CMT]) to determine the extent of treatment needed in this subgroup of stage IIIA patients. MATERIALS AND METHODS We retrospectively reviewed the freedom from relapse (FFR) rate, sites of recurrence, and survival rate of PS III 1A patients selected to receive extended-field irradiation (MPA, n = 27), total-nodal irradiation (TNI, n = 34), and CMT (n = 32) between 1969 and 1987. CMT consisted of six cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy and MPA. Patients treated with MPA were part of a prospective trial designed to reduce treatment to patients with minimal stage III disease with very favorable characteristics. RESULTS Histologic subclass and treatment were the only prognostic factors for FFR and survival rates. Patients with nodular sclerosis or lymphocyte predominance histology had significantly higher FFR and survival rates compared to patients with mixed-cellularity (MC) histology. The 10-year actuarial FFR of PSIII 1A patients treated with MPA was only 39%, versus 55% for TNI (P = .02) and 94% for CMT (v MPA, P < .0001; v TNI, P = .006). The patterns of recurrence in patients who received MPA and TNI were significantly different, with MPA patients relapsing more often in untreated pelvic or inguinal nodes, and TNI patients relapsing more often in extranodal sites with or without nodal sites. The 10-year actuarial overall survival rate for patients treated with CMT was 89% versus 78% for MPA (v CMT, P = .09) and 70% for TNI (v CMT, P = .05). CONCLUSION Patients with PSIII 1A Hodgkin's disease treated with RT have a significantly higher risk of relapse and potentially a poorer survival compared with patients treated with CMT. These findings suggest that CMT should play a greater role in the treatment of this favorable substage of patients. Management with modified chemotherapy and RT in an attempt to reduce long-term treatment-induced complications may be a preferred approach for future trials.

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The in vivo effect of thymic factor (thymostimulin) administration on circulating immune complexes and serum lysozyme levels in untreated Hodgkin's disease patients.

Journal of Clinical Oncology ◽

10.1200/jco.1983.1.2.117 ◽

1983 ◽

Vol 1 (2) ◽

pp. 117-125 ◽

Cited By ~ 4

Author(s):

A Velardi ◽

F Spinozzi ◽

P Rambotti ◽

A Tabilio ◽

A Losito ◽

...

Keyword(s):

Immune Complexes ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Serum Levels ◽

Mean Value ◽

Circulating Immune Complexes ◽

Calf Thymus ◽

Serum Lysozyme ◽

Thymic Factor

The in vivo effect of a calf thymus extract, thymostimulin, on the levels of circulating immune complexes (CIC) and serum lysozyme was evaluated in 32 patients with untreated Hodgkin's disease. Using the platelet aggregation test for detecting CICs, 12 patients (37%) had positive titers before thymostimulin treatment; 3 patients (10%) remained positive following therapy. Serum levels of Clq-binding immune complexes were evaluated (greater than 24.5 micrograms/ml) in 8 patients prior to thymostimulin therapy (mean value: 42.3 micrograms/ml); 3 patients continued to have elevated levels after treatment. Serum lysozyme levels for Hodgkin's patients was similar to control values (10.6 vs. 8.3 micrograms/ml); however, the Hodgkin's patients with initially elevated CICs had a lower serum lysozyme level than patients with initially normal CICs (12.9 vs. 7.3, p less than 0.02). Thymostimulin increased serum lysozyme levels in the Hodgkin's patients in whom the CICs were initially elevated (7.3 vs. 10.4 micrograms/ml, p less than 0.05). These data suggest that thymostimulin exerts an effect on the nonspecific immune system of Hodgkin's disease patients.

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Reaction of Immune Complexes With Hodgkin's Disease Tissue Cultures

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/67.1.3 ◽

1981 ◽

Keyword(s):

Immune Complexes ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Tissue Cultures

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2163 Subdiaphragmatic stage I & II Hodgkin's disease-long-term follow-up and prognostic factors

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(97)80930-3 ◽

1997 ◽

Vol 39 (2) ◽

pp. 322

Author(s):

Zhongxing Liao ◽

Chul S. Ha ◽

Lillian M. Fuller ◽

Fredrick B. Hagemeister ◽

Fernando Cabanillas ◽

...

Keyword(s):

Prognostic Factors ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Stage I ◽

Long Term Follow Up

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Hodgkin’s disease and HIV infection (HD-HIV): Prognostic factors in 596 patients (pts) within the group of European Cooperation on AIDS and Tumors (GECAT).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.8058 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 8058-8058

Author(s):

Michele Spina ◽

Josep-Maria Ribera ◽

Jean Gabarre ◽

Christoph Wyen ◽

Silvia Montoto ◽

...

Keyword(s):

Prognostic Factors ◽

Hiv Infection ◽

Highly Active Antiretroviral Therapy ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

High Dose Chemotherapy ◽

High Dose ◽

Cd4 Cell Count ◽

Highly Active ◽

Cd4 Cell

8058 Background: Hodgkin’s disease (HD) is the most common non-AIDS defining tumour diagnosed in HIV setting. The introduction of highly active antiretroviral therapy (HAART) has opened a new prospective in the treatment of pts with HD-HIV as the better control of the underlying HIV infection allows the use of more aggressive chemotherapy regimens, including high dose chemotherapy. However, up to now prognostic factors on overall survival (OS) or time to treatment failure (TTF) have not yet been identified. Methods: In order to identify prognostic factors, we analyzed data on 596 pts with HD-HIV diagnosed and treated in 90 different Institution of 6 European countries from October 1983 to March 2010. All factors were analyzed for OS and TTF. Results: 86% of pts were male and the median CD4 cell count was 224/dl (range 3-1274); 52% of pts had mixed cellularity subtype, stages III-IV were diagnosed in 72% of cases and 55% of pts had extranodal involvement (bone marrow 35%, spleen 21%, liver 14%). The table summarizes the results of multivariate analysis. Conclusions: We identified a new “European Score” for HD-HIV able to predict different outcomes in these patients. This score should be considered for future prospective studies. [Table: see text]

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